Community Health Nursing
Great challenges and great opportunities.
By Phyllis Meadows, PhD, RN
Downloaded from https://journals.lww.com/ajnonline by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AWnYQp/IlQrHD3Qr4xHpnxR4m/LtafAZSDnhjld4HwI9rxAdy75iSoeWC/ALE590NueQ== on 08/24/2020
M
any challenges influence the overall
health of communities. Infectious dis-
eases, such as tuberculosis, can spiral out
of control in many urban settings. Children’s health
and well-being are still threatened by preventable
diseases, environmental toxins, violence, accidents,
and injuries. Unequal access to health care and
insurance coverage has notably increased morbidi-
ty and mortality among infants, pregnant women,
and other vulnerable populations.
Amid these challenges, all nurses can improve
health outcomes and expand the infrastructure for
monitoring and managing diseases. In traditional
public health settings, community health nurses
work to ensure that expectant and new mothers
have the resources to appropriately care for them-
selves and their children. They can be found in the
WIC Program (the Special Supplemental Nutrition
Program for Women, Infants, and Children) admin-
istering well-baby assessments, vaccinations, and
newborn screenings, as well as in lead abatement
programs managing the care of children with lead
poisoning.
Community health nurses are valued for their
adaptability and willingness to provide care in
many settings, including community health clinics,
churches, homeless shelters, and schools. These
nurses provide comprehensive care to patients with-
in their homes, at organized events such as health
fairs, and at agencies and institutions serving people
who have particular health needs. Advanced prac-
tice nurses in communities improve access to care
and lower costs at nurse-managed clinics on college
campuses and at primary and secondary schools.
They develop and implement corporate wellness
programs, thereby supporting the health and pro-
ductivity of employees and their organizations.
Nurses in community health work with diverse
partners and providers to address complex chal-
lenges in the community. Nowhere is this more evi-
dent than in current efforts to identify, reach, and
treat people living with HIV and AIDS and in efforts
to help the elderly effectively manage their chronic
health problems and remain at home.
The Public Health Security and Bioterrorism
Response Act of 2002 added a new dimension to the
public health professional’s role. It catapulted commu-
nity health nursing to the center of emergency
response plans that would provide mass prophylaxis
and contain and manage biochemical threats. Com-
munity health nurses, especially those in
public health settings, are now considered first respon-
ders—a role that traditionally belonged to law
enforcement and emergency response professionals. In
the event of a public health threat, community health
nurses will organize and administer immediate care.
Community or public health nurses may specialize
in areas such as home care; case management; clinical,
school, or corporate nursing; or pharmaceu-
tical sales. Community health nurses with advanced
degrees can also find opportunities in higher education
and clinical research. The skills needed for these
diverse areas can vary, but at a minimum, nurses
should have a bachelor’s degree and sound clinical
experience. Some public health settings have relaxed
their minimum requirements in response to the nurs-
ing shortage. Nurses who choose traditional public
health or home care should have a broad understand-
ing of health issues and be comfortable with autono-
my, change, and uncertainty.
Nurses entering this specialty must highlight not
only their clinical skills, but also their critical think-
ing, advocacy, and analytical abilities. Communities
are dynamic, and nurses must adapt to be able to pro-
vide patients with whatever care they need. The pay
for community health positions can be lower than
that for similar positions at major health facilities;
however, many community positions require few, if
any, weekend or holiday hours.▼
Phyllis Meadows is the director and health officer of the
Department of Health and Wellness Promotion of the City of
Detroit. Contact author: meadowsp@health.ci.detroit.mi.us.
AJN • CAREER GUIDE 2009 19